“It is difficult to change people but it is worth giving it a shot”

HEALTHCARE-ASSOCIATED INFECTIONS IN GHANA Gifty Sunkwa-Mills is a public health researcher from Ghana especially passionate about one thing: making sure that patients do not leave the hospital with more infections than they arrived with.

Text: Morten Mechlenborg Nørulf / Pictures: Gifty Sunkwa-Mills

Gifty Sunkwa-Mills recently located to Copenhagen for the finalisation of her PhD thesis that is part of the Danida supported project Healthcare Associated infections in Ghana. It was just days before Denmark shut down due to the corona pandemic. Like many others, she is working from home these days so we met her online for a talk about her research and the importance of good hygiene – something so relevant and ever-present in the times we live in right now.

Gifty and her colleagues. Gifty’s PhD is part of a larger research project on healthcare-associated infections in Ghana supported by DANIDA.

Coming in with one disease and leaving with another

As the name implies healthcare-associated infections are infections which patients acquire during healthcare. It is measured as any infection that comes 48 hours after hospital admission. Globally it affects millions of patients and in Ghana a recent study done in ten hospitals, representing 32.9% of all acute care beds in government hospitals, showed that 8,2% of hospitalised patients experience healthcare-associated infections.

Healthcare-associated infections have severe consequences: patients spend more time being hospitalised, it increases morbidity and mortality and the financial burden on the healthcare systems grows.

“In low-income countries having a healthcare-associated infection can cost a patient a lot of money. Coming in with one disease and leaving with another means that you often need to spend more time being hospitalised or having to pay for more medicine if it is not provided for free by the healthcare system, which is often not the case” Gifty explains.

For some people this will pose challenges on making a living. Traders, for example, have to work every day and if they get sick they will lose money. All patients deserve good quality care but the question is: are we really achieving that if they leave the hospitals with more infections than when they arrived.

A major undocumented health burden

One of the big problems of healthcare-associated infections is the lack of data. The surveillance systems that are in place do not capture the reality and the severity of the problem. Compared to other major diseases like malaria, hypertension and cardiovascular diseases, healthcare-associated infections are under-documented. As Gifty puts it: “You simply have too few staff producing reliable data.”

And she is right. 66% of the world’s countries do not have data on healthcare-associated infections or they are underreporting. In high-income countries, healthcare-associated infections can be as low as 3-5% of the hospitalised patients. In low-income countries, good quality studies have shown a prevalence as high as 15,5%. The prevalence study done by Gifty and her colleagues showed a 8,2% prevalence in Ghana in 2019. It varied from hospital to hospital with the highest prevalence being 14,4% and the lowest 3,5%. She further explains:

“Healthcare-associated infections might be one of the top ten burden of diseases in the world for all I know but we don’t know because there is no data on it. If we do not know how serious it is, then it is also hard to alert hospital managers and staff and make them take it seriously.”